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Enbrel and Cancer

I am finally finished with my chemo (i had colon cancer).  I still believe Enbrel had a big part in my cancer. Will be talking to my rheumy dr. this Friday. Anyway, a couple weeks after my last treatment and the lack of steroids, my body crashed! I layed in bed for over  2 weeks. unable to move, unable to walk. My joints were so painful and frozen I thought i would never be mobile again. I couldnt hold a glass to take my meds, let along open the med bottle. I would wake up in the middle of the night and just stare at the ceiling, wishing i could just lift my body a inch so i could move my hip from the pain.
 
I would talk to my dr. nurse for medications, but my dr. couldnt or wouldnt see for for over a month and a half. I am so angry! I was finally place on a Methylprenisonlone packet. It broughtr me back to life, but I am running to the end of its treatment and i can feel my joints freezing again.
 
I truly believe, until proven other wise, Enbrel caused the cancer in my colon. I had taken it for over 5 years with no remission. Also, the cancer grew where my injection spot was located. I read of a 5 year study that Enbrel, besides the Lymphnoma (sp) will cause breast, prostate, and colon cancer. My Onconigist told me she has seen lot of Lymphnoma cancer in those that take Enbrel.
 
I am sorry if I am scaring anyone, I am scared my self.
 
Ivypoe

sorry to hear of your troubles...  I'm glad you're finished w/ treatement.

Did you take an NSAID for your RA?

Sorry to hear this.I'm so sorry. That sounds really hard. I hope you get some relief soon, and that the cancer is over with.

I am very sorry to hear that you have been through so much.  I read up on the effects of Enbrel before I started on the injections, the slight chance of a cancer related side effect worried me too but the statistics were so small . It is good to see both sides of the coin and even if the enbrel was not the cause we do have to be made aware of what we are putting into our bodies. Enbrel is not helping me at all so I will be coming off of it.

Ivy -
 
I'm so sorry to hear of all you've been thru.  Please consider reporting this to the FDA because I'll bet the farm your doc never will.  There are easy links to reporting on the FDA website.
 
Also, please consider checking out www.roadback.org for another way of RA treatment.
 
Hugs and more hugs,
 
Pip
I am so incredibly sorry you've suffered through all that....  No one should have to.
 
The reason I asked about NSAIDs, is that they have chemopreventative properties.. for myself, I did some research when the option to take enbrel was brought to my attention..  while the enbrel "may" have some causative effects... the NSAIDs have chemopreventative properties...  what is more prevalent?  IDK... but this is some of the information I based my decision on...
 

“Things like red wine and grapes, raspberries, black raspberries, blueberries, and strawberries have components in them that are antioxidants that may be chemopreventive. Green tea and garlic, all these are things that probably have active chemicals in them that are very effective at suppressing cancer, but are natural products and therefore generally nontoxic.”

Non-steroidal anti-inflammatory drugs, or NSAIDs, are another category of chemoprevention agents. In addition to commonly used aspirin, they include drugs such as celecoxib (sold under the trade name Celebrex), and sulindac (Clinoril).

Ivy - I join with everyone who has posted - no one who has RA needs to have this happen.  And not to have supportive rheumatologists is just one more insult.  Keep posting, keep letting us know how you are doing, whether it be bad or good.  Huggles ~~ CathyI havent taken NSAID's in a while. Just taking Enbrel and Darvocite for pain the last 5 years. Yes I did report this to the FDA. Wish there had been some kind of feed back but of course there was none. I am trying like hell to eat properly. Couldnt do it while on chemo, I was kind of out of it during the treament, didnt realize it till i was off of it LOL. Ahaa the clarity of thought.OHHHHH and thank you all for your concern. God bless you all !!!RAShirley-
 
What are the statistics for the incidence of cancer caused by Enbrel? or does anyone else know?
Jan Lucinda I was reading an article that gave the stats for RA meds and cancer. I will have a look for itIvy- so sorry you went through this and glad you made it through. Biologics have always scared me with the cancer risk too and so far I haven't had to use them. If I have to I will....unfortunately we never know if we might be in the lucky or unlucky statistic pot.

My thoughts on the cancer risk....  JMHO.

If there are 3 people in a group of 1000 that take enbrel and who get cancer...  what is the percentage versus the percentage of a control group w/ very similar situations/jobs/life styles/etc...  I don't feel you can ever get a real idea of what the percent of our chances are ....  because you still have to factor in all the other meds we may be taking.. environmental issues.. and the chemo antagonists... etc... 

Luckily for many, you've not needed the benefits of a biologic to move... to live..
 
I really hope you remain blessed..
[QUOTE=babs10]
Luckily for many, you've not needed the benefits of a biologic to move... to live..
 

[/QUOTE]

I've always felt that everyone understands that for so many, the benefits truly outweigh any risks.

I think the questioning comes in when they are recommended for patients who are functioning fine without them.  'Early aggressive', is it right for everyone?

Or Ivypoe's case, where it was used for five years even though there was no remission.  Maybe there needs to be some endpoint?

Ivypoe, I'm sorry you have been through this, but thank you for sharing your story and please keep us updated.  Take care.
ah.. I see, Suzanne.. and I agree... five years without the end game being found.... I think is too long also... BUT, if it was what gave her functionality.. and a semblance of a life...   where DO you draw the line?
 
Ivypoe.. I hope you know my questions are not to offend you.. I am here and caring about your plight, but I have my queries that may benefit someone else who is trying to make that decision... to do... or not to do?  kwim?  thanks.
I am not offended...not in the least..learning while reading. everyone view point is very important to me. Keep posting lolhttp://www.sciencedaily.com/releases/2008/12/081230072246.htm [QUOTE=Lynn49]http://www.sciencedaily.com/releases/2008/12/081230072246.htm[/QUOTE]

From the article:
"Bacteria contribute to the development of certain cancers, in some measure, by stimulating chronic inflammation."

Hmmm.
I just looked on the Enbrel/Amgen site for side effects.  It says:
 
In medical studies, more (doesn't say how many more, 5% 10%) cases of lymphoma were seen in pataients taking TNF blockers compared to similar patients who were not taking TNF blockers.
 
The risk of lymphoma may (NOT SURE) be several-fold (what is that) higher in people with RA or psoriasis.
 
The role of TNJ blockers in the development of cancer is unknown.
 
Sounds pretty vague to me.

Coauthor Dr Lars Klareskog (Karolinska University Hospital, Stockholm, Sweden) summarized the clinical implications for rheumawire, "Disease activity rather than treatment with DMARDs is the major determinant for lymphoma development in RA. This means that rheumatologists should be very aware of the lymphoma risk in patients with long-standing high disease activity and that we should not be afraid of but instead encourage use of DMARDs to reduce inflammation in these cases."

Baecklund added that these findings reinforce current approaches to RA treatment, including early arthritis clinics, early introduction of aggressive antirheumatic treatment with disease-modifying drugs and corticosteroids, and efforts to achieve remission of RA.

The study also provides important data on the "background" risk of lymphoma in RA patients for use in clinical trials of new RA drugs.

In an accompanying editorial, Drs Cornelia M Weyand, Jorg J Goronzy, and Paul J Kurtin highlight the study finding that oral steroids reduced the risk of lymphoma (OR 0.6) and that intra-articular steroids reduced the risk by about two thirds [2]. They argue for greater efforts to suppress inflammation in RA, writing, "We can simultaneously suppress rheumatoid inflammation and reduce the risk for lymphoma development."

 
 
THe previous article is the opposite of the Amgen site that says more cases of lymphoma were seen in patients taking TNF blockers than similar patients not taking TNF blockers.

See, this is my problem with this.  They keep saying 'nature of the disease' so hypothetically, any problems can be laid squarely on the disease/person and not the meds.  I mean, there is absolutely no accountability here.

Good catch Suzanne.  There are a ton of researchers linking cancer to microbial infection be it bacterial or viral.  What do we think is going to happen if we suppress with an infection? 
 
Pip
The higher risk for Lymphoma, according to the research that I've both read and posted, is for people who have RA that is severe and poorly controlled.
 

"Our most important findings were that lymphoma risk is significantly increased only in the subset of RA patients with very severe disease activity and that common [disease-modifying antirheumatic drug] DMARD therapy (antimalarials, auranofin, cyclosporine, D-penicillamine, intramuscular gold, methotrexate, or sulfasalazine) is not associated with increased lymphoma risk in RA patients," Baecklund told rheumawire.

Results: 378 RA subjects with a confirmed diagnosis of lymphoma were identified. The mean duration of RA prior to lymphoma diagnosis was 20 years (range 1 59). Most lymphomas (78%) were B cell non-Hodgkins lymphomas, with the majority classified as diffuse large B-cell lymphomas (48%). EBV positivity was uncommon (12% of all lymphomas) and was found predominantly in cases with Hodgkins lymphoma.

Overall disease activity was associated with lymphoma risk, with both medium and high disease activity associated with an higher risk of lymphoma compared to low overall disease activity (OR 7.7 (95% CI 4.8 12.3) and OR 71.3 (95%CI 24.1 211.4) for medium and high disease activity, respectively, compared to low disease activity). Similar associations with lymphoma risk were found for increasing Steinbrocker functional class. Subjects in the highest quartile of mean ESR (> 45 mm/hr) and those with severe irreversible radiographic joint damage also demonstrated an increased lymphoma risk (OR 2.8 (95%CI 1.8 4.4) for ESR in the highest quartile compared to lowest quartile; OR 10.5 (95%CI 6.1 18.2) for severe radiographic joint damage in hands and feet compared with limited radiographic damage).

For cumulative disease activity, no significant association was found between disease activity and lymphoma until the 7th decile of cumulative disease activity, Thereafter, lymphoma risk rose sharply (OR 9.4 (95% CI 3.1 28.0) for the 9th decile compared to the first; OR 61.6 (95% CI 21.0 181.0) for the 10th decile compared to the first).

Seventy percent of cases and controls had received DMARDs (pre-TNF inhibitor era) mostly consisted of anti-malarial treatment, injected gold, and to a lesser extent azathioprine, methotrexate, and sulfasalazine. In addition, glucocorticoid, NSAID, and aspirin use was common. In analyses adjusted for total DMARDs used, no significant associations between therapeutic use and lymphoma were detected.

Conclusions: RA patients with the highest disease activity are the most at risk for lymphoma, primarily of the diffuse large B-cell subtype. RA therapies, including non-biologic DMARDs, glucocorticoids, NSAIDS, or aspirin do not appear to enhance lymphoma risk above that associated with disease activity. In addition, EBV associated lymphomas are uncommon in RA.

See my above post.I did... I disagree.......... Lynn492009-01-15 10:34:18See my post.

The more aggressive your RA, the more likely you are to use a biologic...........Severe, uncontrolled RA ups the risk of Lymphoma.

But what about what Suzanne said.  If they are now saying 'be agressive early' and it's the meds, aren't we going to see a rise in lymphoma rates?  Or colon cancer rates?  Or whatever the cancer is?  It's not like they check for microbes prior to starting us on these meds.
 
Edited to add in word 'cancer'.
Pip!2009-01-15 10:43:27[QUOTE=Pip!]But what about what Suzanne said.  If they are now saying 'be agressive early' and it's the meds, aren't we going to see a rise in lymphoma rates?  Or colon cancer rates?  Or whatever the cancer is?  It's not like they check for microbes prior to starting us on these meds.
 
Edited to add in word 'cancer'.
[/QUOTE]
 
I don't know and neither do you....
 
Edited to add:
 
Uncontrolled inflammation causes a great many issues in RA.  It increases the risk for CVD, artheroscelosis and Lymphoma.  Also aggressive treatment seems wise since the a lot of the damage caused by RA happens in the first couple years of the disease.
 
 
In my opinion, it's better to get RA under control as quickly as possible.....
Lynn492009-01-15 10:53:23I just want to point out Ivanpoe had colon cancer, not lymphoma, and that the cancer started at her Enbrel injection site.

I also believe that people know a lot "intuitively", and if she thinks Enbrel had a role in her developing cancer then it probably did.

If you have to use it, you have to, but there are many other measures people can try first (not all prescribed by your doctor, either) [QUOTE=Lynn49]
 
In my opinion, it's better to get RA under control as quickly as possible.....
[/QUOTE]

But what if your chronic inflammation is not RA but instead chronic inflammation caused by bacteria that also causes cancer, like mentioned in the article you posted?





I told a gal about this who is getting off Enbrel.  She found it important information.Can I ask who smokes?

I'm not sure what you are asking.

RA-
 
Are you wondering if there is a correlation with smoking and the cancer?
 

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